Global, regional, and national burden of osteoarthritis, 1990–2020 and projections to 2050: a systematic analysis for the Global Burden of Disease Study 2021
Authors: Jaimie D Steinmetz, Garland T Culbreth, Lydia M Haile, Quinn Rafferty, Justin Lo, Kai Glenn Fukutaki, Jessica A Cruz, Amanda E Smith, Stein Emil Vollset, Peter M Brooks, Marita Cross, Anthony D Woolf, Hailey Hagins, Mohsen Abbasi-Kangevari, Aidin Abedi, Ilana N Ackerman, Hubert Amu, Benny Antony, Jalal Arabloo, Aleksandr Y Aravkin, Ayele Mamo Argaw, Anton A Artamonov, Tahira Ashraf, Amadou Barrow, Lindsay M Bearne, Isabela M Bensenor, Alemshet Yirga Berhie, Nikha Bhardwaj, Pankaj Bhardwaj, Vijayalakshmi S Bhojaraja, Ali Bijani, Paul Svitil Briant, Andrew M Briggs, Nadeem Shafique Butt, Jaykaran Charan, Vijay Kumar Chattu, Flavia M Cicuttini, Kaleb Coberly, Omid Dadras, Xiaochen Dai, Lalit Dandona, Rakhi Dandona, Katie de Luca, Edgar Denova-Gutiérrez, Samath Dhamminda Dharmaratne, Meghnath Dhimal, Mostafa Dianatinasab, Karsten E Dreinhoefer, Muhammed Elhadi, Umar Farooque, Hamid Reza Farpour, Irina Filip, Florian Fischer, Marisa Freitas, Balasankar Ganesan, Belete Negese Belete Gemeda, Tamiru Getachew, Seyyed-Hadi Ghamari, Ahmad Ghashghaee, Tiffany K Gill, Mahaveer Golechha, Davide Golinelli, Bhawna Gupta, Veer Bala Gupta, Vivek Kumar Gupta, Rasool Haddadi, Nima Hafezi-Nejad, Rabih Halwani, Samer Hamidi, Asif Hanif, Netanja I Harlianto, Josep Maria Haro, Jan Hartvigsen, Simon I Hay, Jeffrey J Hebert, Golnaz Heidari, Mohammad-Salar Hosseini, Mehdi Hosseinzadeh, Alexander Kevin Hsiao, Irena M Ilic, Milena D Ilic, Louis Jacob, Ranil Jayawardena, Ravi Prakash Jha, Jost B Jonas, Nitin Joseph, Himal Kandel, Ibraheem M Karaye, Md Jobair Khan, Yun Jin Kim, Ali-Asghar Kolahi, Oleksii Korzh, Rajasekaran Koteeswaran, Vijay Krishnamoorthy, G Anil Kumar, Narinder Kumar, Sang-woong Lee, Stephen S Lim, Stany W Lobo, Giancarlo Lucchetti, Mohammad-Reza Malekpour, Ahmad Azam Malik, Luiz Garcia Garcia Mandarano-Filho, Santi Martini, Alexios-Fotios A Mentis, Mohamed Kamal Mesregah, Tomislav Mestrovic, Erkin M Mirrakhimov, Awoke Misganaw, Reza Mohammadpourhodki, Ali H Mokdad, Sara Momtazmanesh, Shane Douglas Morrison, Christopher J L Murray, Hasan Nassereldine, Henok Biresaw Netsere, Sandhya Neupane Kandel, Mayowa O Owolabi, Songhomitra Panda-Jonas, Anamika Pandey, Shrikant Pawar, Paolo Pedersini, Jeevan Pereira, Amir Radfar, Mohammad-Mahdi Rashidi, David Laith Rawaf, Salman Rawaf, Reza Rawassizadeh, Seyed-Mansoor Rayegani, Daniela Ribeiro, Leonardo Roever, Basema Saddik, Amirhossein Sahebkar, Sana Salehi, Lidia Sanchez Riera, Francesco Sanmarchi, Milena M Santric-Milicevic, Saeed Shahabi, Masood Ali Shaikh, Elaheh Shaker, Mohammed Shannawaz, Rajendra Sharma, Saurab Sharma, Jeevan K Shetty, Rahman Shiri, Parnian Shobeiri, Diego Augusto Santos Silva, Ambrish Singh, Jasvinder A Singh, Surjit Singh, Søren T Skou, Helen Slater, Mohammad Sadegh Soltani-Zangbar, Antonina V Starodubova, Arash Tehrani-Banihashemi, Sahel Valadan Tahbaz, Pascual R Valdez, Bay Vo, Linh Gia Vu, Yuan-Pang Wang, Seyed Hossein Yahyazadeh Jabbari, Naohiro Yonemoto, Ismaeel Yunusa, Lyn M March, Kanyin Liane Ong, Theo Vos, Jacek A Kopec
Journal: The Lancet Rheumatology (2023)

Osteoarthritis is the most common form of arthritis in adults, characterised by chronic pain and loss of mobility. Osteoarthritis most frequently occurs after age 40 years and prevalence increases steeply with age. WHO has designated 2021-30 the decade of healthy ageing, which highlights the need to address diseases such as osteoarthritis, which strongly affect functional ability and quality of life. Osteoarthritis can coexist with, and negatively effect, other chronic conditions. Here we estimate the burden of hand, hip, knee, and other sites of osteoarthritis across geographies, age, sex, and time, with forecasts of prevalence to 2050.In this systematic analysis for the Global Burden of Disease Study, osteoarthritis prevalence in 204 countries and territories from 1990 to 2020 was estimated using data from population-based surveys from 26 countries for knee osteoarthritis, 23 countries for hip osteoarthritis, 42 countries for hand osteoarthritis, and US insurance claims for all of the osteoarthritis sites, including the other types of osteoarthritis category. The reference case definition was symptomatic, radiographically confirmed osteoarthritis. Studies using alternative definitions from the reference case definition (for example self-reported osteoarthritis) were adjusted to reference using regression models. Osteoarthritis severity distribution was obtained from a pooled meta-analysis of sources using the Western Ontario and McMaster Universities Arthritis Index. Final prevalence estimates were multiplied by disability weights to calculate years lived with disability (YLDs). Prevalence was forecast to 2050 using a mixed-effects model.Globally, 595 million (95% uncertainty interval 535-656) people had osteoarthritis in 2020, equal to 7·6% (95% UI 6·8-8·4) of the global population, and an increase of 132·2% (130·3-134·1) in total cases since 1990. Compared with 2020, cases of osteoarthritis are projected to increase 74·9% (59·4-89·9) for knee, 48·6% (35·9-67·1) for hand, 78·6% (57·7-105·3) for hip, and 95·1% (68·1-135·0) for other types of osteoarthritis by 2050. The global age-standardised rate of YLDs for total osteoarthritis was 255·0 YLDs (119·7-557·2) per 100 000 in 2020, a 9·5% (8·6-10·1) increase from 1990 (233·0 YLDs per 100 000, 109·3-510·8). For adults aged 70 years and older, osteoarthritis was the seventh ranked cause of YLDs. Age-standardised prevalence in 2020 was more than 5·5% in all world regions, ranging from 5677·4 (5029·8-6318·1) per 100 000 in southeast Asia to 8632·7 (7852·0-9469·1) per 100 000 in high-income Asia Pacific. Knee was the most common site for osteoarthritis. High BMI contributed to 20·4% (95% UI -1·7 to 36·6) of osteoarthritis. Potentially modifiable risk factors for osteoarthritis such as recreational injury prevention and occupational hazards have not yet been explored in GBD modelling.Age-standardised YLDs attributable to osteoarthritis are continuing to rise and will lead to substantial increases in case numbers because of population growth and ageing, and because there is no effective cure for osteoarthritis. The demand on health systems for care of patients with osteoarthritis, including joint replacements, which are highly effective for late stage osteoarthritis in hips and knees, will rise in all regions, but might be out of reach and lead to further health inequity for individuals and countries unable to afford them. Much more can and should be done to prevent people getting to that late stage.Bill & Melinda Gates Foundation, Institute of Bone and Joint Research, and Global Alliance for Musculoskeletal Health.